Journal of Infection and Public Health (Apr 2024)

Epidemiological patterns of bacterial and fungal healthcare-associated infection outbreaks in Ministry of Health hospitals in Saudi Arabia, 2020-2021

  • Mohammed A. Kilani,
  • Bashaier A. Aljohar,
  • Yazeed A. Alayed,
  • Najim Z. Alshahrani,
  • Hala R. Shiha,
  • Ghada Bin Saleh,
  • Nasser H. Alshanbari,
  • Khalid H. Alanazi

Journal volume & issue
Vol. 17, no. 4
pp. 551 – 558

Abstract

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Background: Healthcare-Associated Infections (HAI) outbreaks remain a huge challenge to the healthcare sectors worldwide. Their impact on morbidity and mortality, economic and healthcare burden remains a public health problem and a challenge to the HAI surveillance system, infection control, and HAI management strategies. Aim: This study aimed to investigate the epidemiological patterns, distribution, causative agents of HAI outbreaks and the influence of age, COVID-19 co-infection, medical invasive procedures, and hospital units on mortality among HAI outbreaks cases. Methods: This chart review study involved HAI outbreak cases recorded in Ministry of Health hospitals during 2020–2021 in Saudi Arabia. HAI outbreak notification and investigation forms were used for data collection. A binary logistic regression model was performed to determine the significant predictors of mortality. Univariate analyses were performed to determine the association between hospital units, organisms, and COVID-19 co-infection to the site of infection. Results: A total of 217 HAI outbreaks with 1003 cases were recorded in 2020–2021. Gram-negative bacteria were isolated from 73.8% of the cases. The overall specific case fatality rate was 47.5%. The significant predictors of mortality were age, invasive medical procedures, COVID-19 co-infection, and intensive care units’ admission. Moreover, ventilator-associated events were more associated with cases co-infected with COVID-19. Conclusion: HAI outbreaks were most prevalent in the Western and Central region and in intensive care units. Gram negative bacteria were responsible for most of cases while ventilator-associated events and central line-associated bloodstream infections were the most common infection sites. Implementing targeted and effective prevention and control strategies is recommended.

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